European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 2, pp 439–445 | Cite as

Assessment of taste functions in allergic rhinitis patients undergoing allergen-specific immunotherapy

  • Gülpembe BozkurtEmail author
  • Hassan Ahmed Elhassan
  • Esra Sözen
  • Pınar Soytaş
  • Zeynep Nur Erol
  • Melih Güven Güvenç
  • Berna Uslu Coşkun



We evaluated taste functions of patients with perennial allergic rhinitis (AR) before and after allergen-specific immunotherapy (AIT).


The study was designed as a prospective clinical study in our tertiary care hospital. Patients (n = 21) who were diagnosed with perennial AR on the basis of physical examination, skin prick test of at least 3* for HDM allergen and treated with AIT were enrolled in this study. A control group (n = 21) was selected from patients who were given intranasal steroids (INS) for perennial AR. Both groups had self-reported hyposmia and subjective loss of the sense of taste before treatment. Taste strips (Burghart, Wedel, Germany) were used for the taste identification scores before and after 6 months treatment.


A total of 42 subjects were included, with a mean age of 24.1 ± 7.9 years (range 15–43 years). Overall, the AIT group showed more of an improvement of taste function, observed in the total average test scores, compared to the INS group (p < 0.05), but no change was detected between the groups before treatment. No difference was found for the bitter taste scores between the study groups (p = 0.053).


Subcutaneous allergen immunotherapy resulted in more of an improvement in taste function than intranasal steroids. Further studies are needed.


Perennial allergic rhinitis Taste Allergen-specific immunotherapy Olfaction Taste strips 



Allergic rhinitis


Quality of life


Orbitofrontal cortex


Subcutaneous immunotherapy


Allergen-specific immunotherapy


Intranasal steroid



We would like to thank Dr Aytuğ Altundağ for helpful advice concerning the use of the taste strips.

Author contributions

Concept—GB, HAE, ES, BUC; design—GB, HAE, PS, BUC; supervision—HAE, ES; resource—MGG, PS, ZNE; materials—MGG, PS, ZNE; data collection and/or processing—MGG, PS, ZNE; analysis and/or interpretation—GB, HAE, ES; literature search—GB, PS, ZNE, MGG; writing—GB, HAE, ES, BUC; critical reviews—GB, HAE, ES, PS, BUC.

Compliance with ethical standards

Conflict of interest

All of the authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. 1.
    Cowart BJ, Flynn-Rodden K, McGeady SJ, Lowry LD (1993) Hyposmia in allergic rhinitis. J Allergy Clin Immunol 91:747–751CrossRefPubMedGoogle Scholar
  2. 2.
    Rydzewski B, Pruszewicz A, Sulkowski WJ (2000) Assessment of smell and taste in patients with allergic rhinitis. Acta Otolaryngol 120:323–326CrossRefPubMedGoogle Scholar
  3. 3.
    Bollen CM, Beikler T (2012) Halitosis: the multidisciplinary approach. Int J Oral Sci 4:55–63CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Guilemany JM, García-Piñero A, Alobid I et al (2012) The loss of smell in persistent allergic rhinitis is improved by levocetirizine due to reduction of nasal inflammation but not nasal congestion (the CIRANO study). Int Arch Allergy Immunol 158:184–190CrossRefPubMedGoogle Scholar
  5. 5.
    Simola M, Malmberg H (1998) Sense of smell in allergic and nonallergic rhinitis. Allergy 53:190–194CrossRefPubMedGoogle Scholar
  6. 6.
    Katotomichelakis M, Riga M, Davris S et al (2009) Allergic rhinitis and aspirin-exacerbated respiratory disease as predictors of the olfactory outcome after endoscopic sinus surgery. Am J Rhinol Allergy 23:348–353CrossRefPubMedGoogle Scholar
  7. 7.
    Moll B, Klimek L, Eggers G et al (1998) Comparison of olfactory function in patients with seasonal and perennial allergic rhinitis. Allergy 53:297–301CrossRefPubMedGoogle Scholar
  8. 8.
    Guilemany JM, García-Piñero A, Alobid I et al (2009) Persistent allergic rhinitis has a moderate impact on the sense of smell, depending on both nasal congestion and inflammation. Laryngoscope 119:233–238CrossRefPubMedGoogle Scholar
  9. 9.
    Landis BN, Scheibe M, Weber C et al (2010) Chemosensory interaction: acquired olfactory impairment is associated with decreased taste function. J Neurol 257:1303–1308CrossRefPubMedGoogle Scholar
  10. 10.
    Yeomans MR (2006) Olfactory influences on appetite and satiety in humans. Physiol Behav 87:800–804CrossRefPubMedGoogle Scholar
  11. 11.
    Small DM, Prescott J (2005) Odor/taste integration and the perception of flavor. Exp Brain Res 166:345–357CrossRefPubMedGoogle Scholar
  12. 12.
    Savic I, Gulyas B, Larsson M et al (2000) Olfactory functions are mediated by parallel and hierarchical processing. Neuron 26:735–745CrossRefPubMedGoogle Scholar
  13. 13.
    Cerf-Ducastel B, Van de Moortele PF, MacLeod P et al (2001) Interaction of gustatory and lingual somatosensory perceptions at the cortical level in the human: a functional magnetic resonance imaging study. Chem Senses 26:371–383CrossRefPubMedGoogle Scholar
  14. 14.
    Zatorre RJ, Jones-Gotman M, Evans AC et al (1992) Functional localization and lateralization of human olfactory cortex. Nature 360:339–340CrossRefPubMedGoogle Scholar
  15. 15.
    Zald DH, Pardo JV (1997) Emotion, olfaction and the human amygdala: amygdala activation during aversive olfactory stimulation. Proc Natl Acad Sci 94:4119–4124CrossRefPubMedGoogle Scholar
  16. 16.
    Rolls ET, Baylis LL (1994) Gustatory, olfactory, and visual convergence within the primate orbitofrontal cortex. J Neurosci 14:5437–5452CrossRefPubMedGoogle Scholar
  17. 17.
    Cain WS, Murphy CL (1980) Interaction between chemoreceptive modalities of odour and irritation. Nature 284:255–257CrossRefPubMedGoogle Scholar
  18. 18.
    Dalton P, Doolittle N, Nagata H et al (2000) The merging of the senses: integration of subthreshold taste and smell. Nat Neurosci 3:431–432CrossRefPubMedGoogle Scholar
  19. 19.
    Kobal G, Hummel C (1988) Cerebral chemosensory evoked potentials elicited by chemical stimulation of the human olfactory and respiratory nasal mucosa. Electroencephalogr Clin Neurophysiol 71:241–250CrossRefPubMedGoogle Scholar
  20. 20.
    Topuz B ed (2010) Turkiye Klinikleri. J Allergy Spec Top 3:43–47Google Scholar
  21. 21.
    Önerci M ed (2007) Medical treatment in allergic rhinitis. Curr Man Otorhinolaryngol Head Neck Surg 3:44–48Google Scholar
  22. 22.
    Kiel MA, Röder E, Gerth van Wijk R et al (2013) Real-life compliance and persistence among users of subcutaneous and sublingual allergen immunotherapy. J Allergy Clin Immunol 132:353–360CrossRefPubMedGoogle Scholar
  23. 23.
    Egert-Schmidt A, Kolbe JM, Mussler S et al (2014) Patients’ compliance with different administration routes for allergen immunotherapy in Germany. Patient Prefer Adherence 8:1475–1481CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Jacopsen L, Dreborg S, Moller C (1996) Immunotherapy as a preventive treatment. J Allergy Clin Immunol 97:232CrossRefGoogle Scholar
  25. 25.
    Burks AW, Calderon MA, Casale T et al (2013) Update on allergy immunotherapy: American Academy of Allergy, Asthma and Immunology/European Academy of Allergy and Clinical Immunology/PRACTALL consensus report. J Allergy Clin Immunol 131:1288–1296CrossRefPubMedGoogle Scholar
  26. 26.
    Soter A, Kim J, Jackman A, Tourbier I, Kaul A, Doty RL (2008) Accuracy of self-report in detecting taste dysfunction. Laryngoscope 118:611–617CrossRefPubMedGoogle Scholar
  27. 27.
    Mueller C, Kallert S, Renner B et al (2003) Quantitative assessment of gustatory function in a clinical context using impregnated ‘‘taste strips”. Rhinology 41:2–6PubMedGoogle Scholar
  28. 28.
    Brożek JL, Bousquet J, Agache I et al (2017) Allergic Rhinitis and its impact on Asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol 140:950–958CrossRefPubMedGoogle Scholar
  29. 29.
    Doty RL, Shah M, Bromley SM (2008) Drug-induced taste disorders. Drug Saf 31:199–215CrossRefPubMedGoogle Scholar
  30. 30.
    Landis BN, Welge-Luessen A, Brämerson A et al (2009) “Taste Strips” a rapid, lateralized, gustatory bedside identification test based on impregnated filter papers. J Neurol 256:242–248CrossRefPubMedGoogle Scholar
  31. 31.
    Pingel J, Ostwald J, Pau HW et al (2010) Normative data for a solution-based taste test. Eur Arch Otorhinolaryngol 267:1911–1917CrossRefPubMedGoogle Scholar
  32. 32.
    Cain WS (1974) Contribution of the trigeminal nerve to perceived odor magnitude. Ann N Y Acad Sci 237:28–34CrossRefPubMedGoogle Scholar
  33. 33.
    Hummel T, Barz S, Lotsch J et al (1996) Loss of olfactory function leads to a decrease of trigeminal sensitivity. Chem Senses 21:75–79CrossRefPubMedGoogle Scholar
  34. 34.
    Hilberg O (1995) Effect of terfenadine and budesonide on nasal symptoms, olfaction, and nasal airway patency following allergen challenge. Allergy 50:683–688CrossRefPubMedGoogle Scholar
  35. 35.
    Wallace DV, Dykewicz MS, Bernstein DI et al (2008) The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol 122:S1–S84CrossRefPubMedGoogle Scholar
  36. 36.
    Calderon MA, Alves B, Jacobson M et al. Allergen injection immunotherapy for seasonal allergic rhinitis. Cochrane Database Syst Rev 2007:CD001936Google Scholar
  37. 37.
    Durham SR, Emminger W, Kapp A et al (2010) Long-term clinical efficacy in grass pollen-induced rhinoconjunctivitis after treatment with SQ standardized grass allergy immunotherapy tablet. J Allergy Clin Immunol 125:131–138CrossRefPubMedGoogle Scholar
  38. 38.
    McHugh SM, Lavelle B, Kemeny DM et al (1990) A placebo controlled trial of immunotherapy with two extracts of Dermatophagoides pteronyssinus in allergic rhinitis, comparing clinical outcome with changes in antigen-specific IgE, IgG, and IgG subclasses. J Allergy Clin Immunol 86:521–531CrossRefPubMedGoogle Scholar
  39. 39.
    Bousquet PJ, Demoly P, Passalacqua G et al (2007) Immunotherapy: clinical trials—optimal trial and clinical outcomes. Curr Opin Allergy Clin Immunol 7:561–566CrossRefPubMedGoogle Scholar
  40. 40.
    Varney VA, Tabbah K, Mavroleon G et al (2003) Usefulness of specific immunotherapy in patients with severe perennial allergic rhinitis induced by house dust mite: a double-blind, randomized, placebocontrolled trial. Clin Exp Allergy 33:1076–1082CrossRefPubMedGoogle Scholar
  41. 41.
    Heckmann JG, Stossel C, Lang CJ et al (2005) Taste disorders in acute stroke: a prospective observational study on taste disorders in 102 stroke patients. Stroke 36:1690–1694CrossRefPubMedGoogle Scholar
  42. 42.
    Kamel UF (2004) Hypogeusia as a complication of uvulopalatopharyngoplasty and use of taste strips as a practical tool for quantifying hypogeusia. Acta Otolaryngol 124:1235–1236CrossRefPubMedGoogle Scholar
  43. 43.
    Nordin S, Bramerson A, Bringlov E et al (2007) Substance and tongue-region specific loss in basic taste-quality identification in elderly adults. Eur Arch Otorhinolaryngol 264:285–289CrossRefPubMedGoogle Scholar
  44. 44.
    Landis BN, Giger R, Dulguerov P et al (2007) Gustatory function after microlaryngoscopy. Acta Otolaryngol 127:1086–1090CrossRefPubMedGoogle Scholar
  45. 45.
    Mueller CA, Khatib S, Landis BN, Temmel AF, Hummel T (2007) Gustatory function after tonsillectomy. Arch Otolaryngol Head Neck Surg 133:668–671CrossRefPubMedGoogle Scholar
  46. 46.
    Pavlidis P, Gouveris H, Kekes G (2017) Electrogustometry thresholds, tongue tip vascularization, density, and form of the fungiform papillae following smoking cessation. Chem Senses 42:419–423CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OtorhinolaryngologyAcıbadem University HospitalIstanbulTurkey
  2. 2.Lewisham University HospitalLondonUK
  3. 3.Department of Otorhinolaryngology, School of MedicineAydın UniversityIstanbulTurkey
  4. 4.Department of OtorhinolaryngologySisli Hamidiye Etfal Education and Research HospitalIstanbulTurkey
  5. 5.Department of OtolaryngologyHopa State HospitalArtvinTurkey
  6. 6.Department of Otorhinolaryngology, School of MedicineAcibadem UniversityIstanbulTurkey

Personalised recommendations